Report (113) Signature Certificate RightSignature
Document Reference: Fa)ISEJJ5KN9TGHKYIXGL7 Easy Online Document Signing
jcclin7gmail.com
Party ID: NMJUGPJMJ2ETZKR8PLPE8C 44 °•C
IP Address:39.9.126.14
VA [VERIFIED EMAIEMAIL.jcclin7@gmail.com
Ding to Fingerprint Checksum e1+69197abf0c06f43d62c023e058a91959b9b0b3 111111.rE ll1lVJL>t� �L76 j 1'�''t 11 111
Pat Killeen
irifib-!v42-4,44:0 I Party ID: RARYMBIIYJHYNJ5TBTFLEY
IP Address:50.252.8.105
I VERIFIED EMAIL: pat@equitygroupinsurance.com
Ar
DgitaFingerprintChecksum 69eb792c66ed04bbbb5a7d30d816fabbe5efa50c liii �� R71G�7L �IfYI'I'' 12 I1' 11111
•
Timestamp Audit
2018-07-27 15:29:23-0700 All parties have signed document.Signed copies sent to:jcclin7gmail.com and
Pat Killeen.
2018-07-27 15:29:23-0700 Document signed by jcclin7gmail.com(jcclin7@gmail.com)with drawn signature.
-39.9.126.14
2018-07-27 14:20:09-0700 Document viewed by jcclin7gmail.com(jcclin7@gmail.com).-39.9.126.14
2018-07-27 09:08:17-0700 Document signed by Pat Killeen(pat@equitygroupinsurance.com)with drawn
signature.-50.252.8.105
2018-07-27 09:07:50-0700 Document viewed by Pat Killeen(pat@equitygroupinsurance.com).-50.252.8.105
2018-07-27 09:07:50-0700 Document created by Pat Killeen(pat@equitygroupinsurance.com).-
50.252.8.105
E 4;o
'Jill"( This signature page provides a record of the online
activity executing this contract. Page 1 of 1
❑ - .